Class III malocclusion camouflage treatment in adults: A Systematic Review

Pinzan, Arnaldo; Castillo, Aron Aliaga–Del; Janson, Guilherme; Sakoda, Karine Laskos; Cury, Sérgio Elias Neves; Bellini-Pereira, Silvio Augusto

doi:10.31487/j.jdoa.2019.01.04

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…9 However, Class III intermaxillary elastics can promote extrusion of upper molars, proclination of upper incisors, distal tipping of lower molars, and extrusion of lower incisors. 9,10 In some studies, a combination of skeletal anchorage and intermaxillary elastics were used to minimise the unwanted effects of intermaxillary elastics alone. 11,12 This case report demonstrates a camouflage treatment in an adult patient with skeletal Class III malocclusion by the extraction of lower first premolars with the use of intermaxillary elastics and no additional appliances.…”

Section: Introductionmentioning

confidence: 99%

Orthodontic camouflage treatment using a passive self-ligating system in skeletal Class III malocclusion

Monika

Widayati

2020

Dent. J.

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Background: The treatment options for adults with skeletal Class III malocclusion can be dentoalveolar compensation, also known as orthodontic camouflage, or orthognathic surgery. Camouflage treatment can be carried out with teeth extractions, distalisation of the mandibular dentition, and use of Class III intermaxillary elastics. However, intermaxillary elastics as anchorage has its own risk–benefit. Purpose: To explain that camouflage treatment with teeth extractions can be performed in a mild to moderate skeletal Class III malocclusion using intermaxillary anchorage with elastics, while minimising the deleterious effects and achieving a satisfactory treatment outcome. Case: Our patient was a 25-year-old female who had a skeletal Class III pattern, with normal maxilla and a protruded mandible. She had a straight facial profile with a Class III canine and molar relationship on her right and left sides. Anterior crossbite was also present with crowding on both the maxilla and the mandible. Case Management: The treatment plan was carried out with dentoalveolar compensation by extracting teeth. Extraction of the lower first premolars was conducted to eliminate the crowding and correct the anterior crossbite. The mandibular incisors were retroclined and the maxillary incisors were proclined with dentoalveolar compensation. Passive self-ligating system was used with standard torque prescription, intermaxillary anchorage, and no additional appliances for anchorage control. Class I canine and incisor relationship were both achieved at the end of the treatment, while maintaining the Class III molar relationship. Conclusion: Orthodontic camouflage treatment in an adult patient using a passive self-ligating system and intermaxillary anchorage can improve facial profile and improve dental occlusion.

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Section: Introductionmentioning

confidence: 99%

Orthodontic camouflage treatment using a passive self-ligating system in skeletal Class III malocclusion

Monika

Widayati

2020

Dent. J.

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“…There were little effects to soft tissue referring to previous studies reported the increases of upper and lower lip thicknesses of 0.7 and 1.2 mm, respectively(73) and a reduction of the H-angle approximately 1.48 degree(74). For class III intermaxillary elastic, the effects were proclination of maxillary incisors, extrusion of maxillary molars, distal tipping of mandibular molars, extrusion of mandibular incisors result in clockwise rotation of the mandibular plane angle and increase in the lower anterior face height(75). There was one case that used temporary anchorage devices (TADs) for camouflaged class III malocclusion producing distal tipping and intrusion of the mandibular molars, bodily movement of the mandibular incisors and reduced mandibular plane angle.…”

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confidence: 69%

Assessing treatment outcomes from the postgraduate orthodontic program, Chulalongkorn university

Kongboonvijit

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Objective: To evaluate the quality of orthodontic treatment outcomes by using Peer Assessment Rating index (PAR), American Board of Orthodontics Objective Grading System (ABO-OGS) and lateral cephalometric analysis in the cases completed from the postgraduate orthodontic clinic, Chulalongkorn University. And to determine whether any contributing factors correlate with the orthodontic treatment outcomes. Materials and Methods: 100 patients who had completed treatment since 2017 were included in this study. Inclusion criteria included patients with full upper and lower edgewise appliances and completed treatment records. Exclusion criteria included patients with craniofacial syndromes or debond before treatment completion. One calibrated examiner assessed DI, pretreatment PAR index and lateral cephalometric analysis. To evaluated treatment outcomes, ABO-OGS, posttreatment PAR index and lateral cephalometric analysis were assessed. Patient data included age, gender, Angle’s classification, types of treatment and treatment duration were also collected. The reliability and validity of the measurements were evaluated using the intraclass correlation coefficient (ICC). Data were analyzed with Wilcoxon signed ranks test, Pearson Chi-square test, Spearman rank correlation, univariate and multivariate linear regression models. Results: Of the 100 patients, 58% were females and 42% were males. The mean age of the sample was 19.22±7.01 years. The types of malocclusion were included: 33% Class I, 33% Class II, and 34% Class III. 47% were camouflaged, 19% were surgery and 5% received 2-phase treatment. The average treatment time was 36.28±8.21 months, with a range from 14 to 57 months. ICC showed very good intra-observer and inter-observer reliability in every index. The analysis showed that the average DI score was 25.69±16.12 points. The mean pretreatment and posttreatment PAR scores were 33.53±12.42 and 0.48±0.67 points respectively. 77% were greatly improved and 23% improved. The average score of ABO-OGS was 11.38±6.34 points. 91% were in the pass group and 9% undetermined. After treatment, there were statistically significant improvements in ANB, Wits, LI-NB (mm), UI-LI, upper lip to E-line and H-angle (p-value<0.01). Spearman rank correlation and linear regression models showed no statistically significant correlation between DI score, pretreatment PAR score, age and gender to posttreatment PAR score and ABO-OGS score. Meanwhile, pretreatment FMA and treatment duration were statistically significant correlated with posttreatment PAR score (p-value<0.05). There were statistically significant correlation between initial Angle’s classification, pretreatment ANB, Wits, LI-NB angle, types of treatment and treatment duration with ABO-OGS score (p-value<0.05). Conclusion: Most of the patients treated in the postgraduate orthodontic clinic, Chulalongkorn University had satisfactorily orthodontic treatment outcomes. Initial severity of skeletal discrepancy and duration of treatment were significantly associated with the quality of the final outcomes.

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Current Trends in Skeletal Borderline Patients: Surgical versus Orthodontic Treatment Decisions—What Is the Evidence?

et al. 2022

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Background: The aim is to assess the current evidence-based knowledge about treatment decisions for skeletal malocclusion in adult borderline patients. Methods: A literature search was conducted through three databases. Inclusion criteria were restricted to systematic reviews, prospective, retrospective, and control studies. Only articles comparing orthodontic camouflage and orthognathic surgical treatment for Class II and Class III malocclusions in adult patients were selected to be reviewed. Results: Seven articles concerning Class II and nine concerning Class III met the inclusion criteria. Scientific evidence was poor due to low methodological quality. Conclusions: Surgical treatment was found to better improve skeletal and soft-tissue cephalometric values, whereas camouflage treatment mainly involved dentoalveolar movements. Aesthetic changes, as perceived by the patient, were not significantly different in the two groups. Recently improved surgical techniques, differing from those described in the analyzed articles, may provide similar or more stable outcomes compared with orthodontic-only treatment. Although some cephalometric variables can be helpful, the most important parameters for treatment selection are the patient’s presenting complaint and their self-image perception. Further studies with larger sample sizes and similar pretreatment conditions, and considering patient self-evaluation of esthetics and function, should be undertaken.

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Class III malocclusion camouflage treatment in adults: A Systematic Review

Cited by 3 publications

References 19 publications

Orthodontic camouflage treatment using a passive self-ligating system in skeletal Class III malocclusion

Orthodontic camouflage treatment using a passive self-ligating system in skeletal Class III malocclusion

Assessing treatment outcomes from the postgraduate orthodontic program, Chulalongkorn university

Current Trends in Skeletal Borderline Patients: Surgical versus Orthodontic Treatment Decisions—What Is the Evidence?

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